NICU Named Best Nursing Team

It takes a talented team with a shared vision to accomplish great things. Such a team exists in the Children’s Hospital Central California Neonatal Intensive Care Unit (NICU). Its nurses’ dedication to the Hospital’s smallest patients garnered it ADVANCE for Nurses Magazine 2009 “Best Nursing Team” award.

“This is a great honor and wonderful recognition for one of our top nursing teams,” said Beverly Hayden-Pugh, Vice President and Chief Nursing Officer, Children’s Hospital. “We know our NICU nurses are providing the best care out there, and now so does everyone else.”

ADVANCE for Nurses evaluated nursing teams in 12 different areas, providing scores in subjects like dealing with change, promoting ongoing education and working effectively as a team.

The Children’s Hospital NICU team scored high in all areas, not a surprise to Hayden-Pugh. “They are truly a dedicated team of nursing professionals who work hard together to create one of the top NICUs in the state of California. We have empowered them to make decisions about practice, education and quality, and they have used it at great benefit to the unit.”

Some of the nursing-based NICU initiatives detailed in the award nomination were:

Enhancing the “Kangaroo Care” policy to define and promote the incredible benefits to mothers, fathers, and babies.

Redesigning the waiting room and visiting policy to be more consistent with Children’s Hospital’s family-centered care philosophy.

Establishing a Developmental Care task force to focus on promoting development of neonates through various age-appropriate interventions.

Facilitating and encouraging professional development through support of specialty certification for nurses.

Developing a clinical “pocket resource book” for new nurses.

The award nomination acknowledged the nursing team’s role in a NICU expansion that added 23 private and semi-private rooms in October 2008, bringing the total bed count to 88. Children’s Hospital has the only Regional Level III NICU in Central California and is the first children’s hospital in the state to offer private NICU rooms, which allows parents to remain at their baby’s bedside throughout their stay.

“The nurses were integral in developing new work flow processes and cues and redesigning how they operate in that new space,” said Randy Guerrero, BSN, RN, NE-BC, executive director of critical care services. “They learned new ways to communicate and hand off care of a patient.”

Community-based efforts leading to the award included the annual “Preemie Graduate Picnic” held for nearly 30 years. The event brings together former NICU patients, staff and families to celebrate their success.

“It is a way for both staff and families to recognize the good that comes from what we do,” said Guerrero. “To see those neonates who have matured and grown, and to reflect on where they started as a preemie, has been great.”

Additionally, the nomination noted two Children’s Hospital’s NICU nurses who are developing neonatal curriculum to support the initiation of a NICU in Nepal. They traveled there in June to offer their expertise.

“This is a display of their love for the field of nursing and specifically neonatal care,” said Guerrero. “Their commitment goes beyond these walls into the broader community in their efforts to heighten the knowledge and skill of nurses to support neonates.”

Children’s Hospital’s outcomes with neonates weighing under 1,500 grams is consistently better than other Level III centers statewide. Their adjusted mortality rate for this population is 9.2 percent compared to a 12.2 percent California average. Children’s Hospital’s “case-mix index” (a number that compares the severity of different populations), is the fourth highest of all 37 NICUs in a nationally comparative database. In other words, on average, the babies who come to Children’s are more seriously ill than those who come to 33 of the other NICUs, and yet they have better results than all of their regional peers.

“All of us consider it to be a very big honor to receive the Best Nursing Team award and the staff is thrilled,” said NICU Manager Susan Keogh, MSN, RNC-NIC. “They feel empowered and know they are the ones driving the changes that make a difference.”

This award comes in addition to Children’s Magnet Recognition Award for Excellence in Nursing Services from the American Nurses Credentialing Center. Children’s was the first pediatric hospital west of the Rockies to achieve Magnet status in 2004, along with redesignation in 2008, and remains one of only 5 percent of hospitals in the nation to have raised their nursing services to this world-class level.